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Objective:To explore the application value of objective structured radiology examination (OSRE) in clinical skills assessment of medical imaging technology, and evaluate the repeatability of the assessment tool.Methods:A total of 55 interns majoring in medical imaging technology were randomly divided into 11 groups (5 in each group), and 9 different cases of OSRE were designed. Each student had to complete 3 cases of OSRE. Five senior attending doctors or deputy chief physicians independently evaluated each case of OSRE. Two months after the internship, three cases of OSRE were randomly selected for scoring to evaluate the internal consistency between raters and the repeatability of the evaluation method. SPSS 16.0 was used for statistical analysis, and multiple linear regression was used to analyze the correlation between academic qualifications and OSRE scores.Results:The OSRE average score of all the students was (12.0±4.9), and the average ICC range between evaluators was 0.36 to 0.80 ( P < 0.001). The consistency of 6 cases was good, that of case 3 was poor, and that of cases 6 and 7 was moderate. After 2 months, the ICC of 4 raters was equal to or greater than 0.8 (excellent consistency), and the ICC of rater 3 was 0.68, and the average original score difference ranged from -1 to 0.8. In multiple linear regression, the OR value of education was 0.90 (95% confidence interval 0.30-1.50, P = 0.01), and education was positively correlated with OSRE score. Conclusion:The OSRE aims to assess clinical skills and knowledge in a standardized clinical environment through the use of pre-set standard scoring scales, so that clinical knowledge can be evaluated in a high-level and repeatable manner.
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Objective:To evaluate the effect of film reading of the case based on flipped classroom in the teaching of medical imaging interns.Methods:Forty undergraduates majoring in medical imaging technology in Kangda College of Nanjing Medical University were selected as the research objects, and they were randomly divided into group A (experimental group) and group B (control group). The flipped classroom teaching of imaging performance of "basic chest lesions" was conducted respectively in the two groups, and group A conducted film reading of the case on the flipped classroom. The scores of written test and film reading of the two groups were compared, and the differences of students' subjective feelings were analyzed by questionnaires. SPSS 20.0 was used for chi-square test and t test. Results:The scores of written test and film reading in group A [(87.32±8.11) points and (85.54±5.23) points] were higher than those in group B [(81.20±9.76) points and (79.03±6.01) points], with statistical significance ( P<0.05). The seven subjective evaluations of group A were higher than those of group B, with statistical significance ( P<0.05). Conclusion:Film reading of the case based on flipped classroom can stimulate students' interest in learning and cultivate their clinical practice ability and critical thinking, which is an effective teaching mode.
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Objective:To investigate the effect of water-fat separation (Dixon) and spectrally selective attenuated inversion recovery (SPAIR) on fat suppression in the neck.Methods:From June to December 2018, 35 patients, including 16 males and 19 females, aged 23-75 (46±13) years old underwent MRI examinations of cervical vertebrae in Sir Run Run Hospital Affiliated to Nanjing Medical University. The imaging data of Dixon and SPAIR fat suppression scanning were prospectively collected. The scanning sequences included Dixon VIBE-T 1WI, SPAIR VIBE-T 1WI, Dixon TSE-T 2WI and SPAIR TSE-T 2WI. According to the subjective evaluation, the quality of fat suppression was divided into 0-4 grades. The cases with clear depiction of the thyroid tissue on Dixon or SPAIR were counted. Fisher exact test and paired t test or rank sum test were used to compare the noise, SNR and CNR of mandible angle, glottis, thyroid and sternoclavicular joint. Results:There were 29 cases of grade 0, 4 cases of grade 1, 2 cases of grade 2 on Dixon VIBE-T 1WI, 4 cases of grade 3 and 31 cases of grade 4 on SPAIR VIBE-T 1WI group, and the difference was statistically significant ( P<0.05); 28 cases of grade 0, 5 cases of grade 1 and 2 cases of grade 2 on Dixon TSE-T 2WI, 33 cases of grade 3 and 4 on SPAIR TSE-T 2WI, and the difference was statistically significant ( P<0.05). There were 35 cases with clear depiction of the thyroid tissues on DIXON and 4 cases on SPAIR VIBE-T 1WI ( P<0.05); there were 35 cases on DIXON and 3 cases on SPAIR TSE-T 2WI ( P<0.05). At the level of mandible angle, for the SNR of sternocleidomastoid muscle, SNR and CNR of splenius capitis muscle on VIBE-T 1WI, Dixon images were better than those on SPAIR images, and the difference was statistically significant ( P<0.05); the noise, SNR of sternocleidomastoid and splenius capitis muscle on TSE-T 2WI images were more than those in SPAIR images, and the difference was statistically significant ( P<0.05). At the level of glottis, the SNR of sternocleidomastoid muscle and levator scapulae muscle in the sequence of VIBE-T 1WI and Dixon images were significantly higher than those on the images of SPAIR ( P<0.05); the noise and SNR of sternocleidomastoid muscle on Dixon TSE-T 2WI images were significantly higher than those on the images of SPAIR ( P<0.05). At the thyroid level, the noise of Dixon VIBE-T 1WI image was less than that of SPAIR image, the SNR of sternocleidomastoid muscle and levator scapulae muscle on Dixon images was greater than that of SPAIR image, and the difference was statistically significant ( P<0.05); For TSE-T 2WI sequence, the SNR of sternocleidomastoid muscle on Dixon image was greater than that on SPAIR image, and the difference was statistically significant ( P<0.05). At the level of sternoclavicular joint, there were no significant differences for noise, SNR and CNR between the two groups ( P>0.05). Conclusion:Dixon outperforms SPAIR in obtaining better image quality and suppression effect in terms of neck MRI scanning.
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Objective:To explore the application value of dynamic monitoring of serum soluble interleukin-2 receptor (sIL-2R) and stromal cell-derived factor 1 α (SDF-1α) in patients with acute leukemia (AL).Methods:A total of 187 patients with AL admitted to the Second Hospital of Shanxi Medical University from March 2017 to August 2018 were selected and 90 healthy subjects at the same period were selected as the healthy controls. The levels of serum sIL-2R and SDF-1α were detected at the initial diagnosis, remission phase and relapse phase, respectively. The clinical value of dynamic monitoring of sIL-2R and SDF-1α was analyzed.Results:Among 187 patients with AL, 135 patients (72.19%) had complete remission (CR) after chemotherapy, 52 patients (27.81%) had partial remission, and 43 patients (31.85%) relapsed. The level of serum sIL-2R at the AL initial diagnosis period was (533±32) U/ml, which was higher than that in the healthy controls [(247±30) U/ml], and the difference was statistically significant ( t = 71.976, P < 0.01); the level of serum SDF-1α at the AL initial diagnosis was (2 968±305) pg/ml, which was higher than that in the healthy controls [(1 358±160) pg/ml], and the difference was statistically significant ( t = 47.043, P < 0.01). The levels of serum sIL-2R [(308±30) U/ml] and SDF-1α [(1 576±184) pg/ml] in the CR phase were lower than those in the initial diagnosis of patients with AL; and the levels of sIL-2R [(599±36) U/ml] and SDF-1α [(2 894±301) pg/ml] in the relapse phase were higher than those in the CR phase of patients with AL (all P < 0.01). Conclusions:The levels of serum sIL-2R and SDF-1α in patients with AL are increased, and there are big differences in the levels of sIL-2R and SDF-1α at the initial diagnosis, remission phase, and relapse phase. Dynamic monitoring of both can provide the data support for early clinical intervention.
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Objective To investigate oxycodone hydrochloride injectio in treatment of postoperative laparoscopic cholecystectomy and its effects on analgesia and levels of 5-hydroxytryptamine(5-HT),nitric oxide(NO),substance P(SP).Methods 90 patients of underwent laparoscopic cholecystectomy who received therapy from August 2013 to August 2016 in Hangzhou Tvaditional chinese Medical hospital were selected and randomly divided into observation group and control group,45 cases in each group.Before incision,the observation group were gived intravenous oxycodone hydrochloride injection 0.1mg/kg,the control group were gived intravenous sufentanil 0.2μg/kg.The changes of anesthesia,postoperative pain,adverse reactions and 5-HT,NO and SP after operation were compared between the two groups.ResultsThere was no significant difference in the anesthesia time,operation time,spontaneous breathing recovery time,wake up of time between two groups,after postoperative two,four,24 h,the scores of incision pain,visceral pain in the observation group were lower than the control group,the difference was statistically significant(P<0.05).After the operation,the levels of 5-HT,NO,SP of two groups were changed,the difference was statistically significant(P<0.05),but the results in observation group were lower than the control group,the difference was statistically significant(P<0.05),the total incidence of postoperative adverse reactions in observation group were lower than the control group,the difference was statistically significant(P<0.05).Conclusion Oxycodone hydrochloride injection is well for laparoscopic cholecystectomy,which can effectively reduce the release of 5-HT,NO,SP,relief of postoperative pain,high security.
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0.05 ). The rate of hypertensive gastropathy, compared with PCDV (66.74%), was significantly attenuated in patiens who underwent PCDV+ORP (22.78%, P
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Objective To investigate the effects of exogenous prostaglandin E 1 (PGE 1) on expression of platelet derived growth factor B (PDGF-B) mRNA and its receptor ? protein in rabbit with schistosomiasis. Methods In this study, 14 rabbits were infected with cercaria of S. japonicum percutaneously. PGE 1 ( 2.5 ?g/kg?d -1 ) was given intravenously to 7 rabbits from the 60th day to day 120. The expressions of PDGF-B mRNA, PDGFR ? protein and ?-SMA were detected by RT-PCR, Western blotting and immunohistochemistry, respectively. Endogenous IFN-? was measured by in situ hybridization. Results Up-regulated expressions of PDGF-B mRNA, receptor ? protein as well as ?-SMA were observed in rabbits with Schistosome hepatic fibrosis. The increased expressions of PDGF mRNA and receptor ? were suppressed in rabbits treated with exogenous PGE 1 (29.42?5.05 vs 41.37?7.23, P